Objective: To explore therapeutic effect of carvedilol combined valsartan on chronic heart failure (CHF), and its influence on cardiac function and level of high sensitive C reactive protein (hsCRP).Methods: A total of 78 CHF patients, who were treated in our hospital from Jul 2011 to Jul 2015, were selected.According to therapeutic method, they were divided into valsartan group (n=38, received valsartan based on routine treatment) and combined treatment group (n=40, received carvedilol based on valsartan group).Therapeutic effect, cardiac function, serum hsCRP level and quality of life (QOL) score before and after treatment were observed and compared between two groups.Results: Total effective rate of combined treatment group was significantly higher than that of valsartan group (92.50% vs.71.05%), P=0.022.Compared with before treatment, there were significant reductions in heart rate, cardiothoracic ratio (C/T), left ventricular end-diastolic dimension (LVEDd) and serum hsCRP level, and significant rise in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), emotional index, health index and life satisfaction score in both groups after treatment except C/T of valsartan group, P<0.01 all;compared with valsartan group after treatment, there were significant reductions in heart rate [(124.39±10.07) beats/min vs.(101.18±8.72) beats/min], C/T [(0.63±0.15) vs.(0.53±0.12)], LVEDd [(43.32±4.02)mm vs.(40.38±3.76)mm] and serum hsCRP level [(32.12±3.99) pg/ml vs.(10.29±2.08) pg/ml], and significant rise in LVEF [(45.59±9.99)% vs.(59.97±10.02)%], LVFS [(24.58±5.67)% vs.(31.89±6.68)%], scores of emotional index [(70.20±10.02) scores vs.(86.58±12.28) scores], health index [(73.36±8.08) scores vs.(85.58±11.01) scores] and life satisfaction [(74.34±8.39) scores vs.(88.12±13.35) scores] in combined treatment group,P<0.05 or <0.01.Conclusion: Carvedilol combined valsartan possesses significant therapeutic effect on chronic heart failure.It can significantly reduce hsCRP level, improve cardiac function and quality of life in these patients, which is worth extending.%目的:探讨卡维地洛联合缬沙坦治疗慢性心力衰竭(CHF)的疗效及其对心功能、高敏C反应蛋白(hsCRP)水平的影响.方法:选择2011年7月至2015年7月我院收治的78例CHF患者,按照治疗方法分为缬沙坦组(38例,在常规治疗基础上接受缬沙坦治疗)与联合治疗组(40例,在缬沙坦组基础上加用卡维地洛).观察比较两组临床疗效,治疗前后的心功能和血清hsCRP水平,以及生活质量评分.结果:联合治疗组的治疗总有效率显著高于缬沙坦组(92.50%比71.05%),P=0.022.与治疗前比较,治疗后两组心率、心胸比率(C/T)、左室舒张末期内径(LVEDd)和血清hsCRP水平均显著降低,左室射血分数(LVEF)、左室短轴缩短率(LVFS)、情感指数、健康指数和生活满意度评分显著升高(缬沙坦组的C/T除外),P均<0.01;与缬沙坦组比较,治疗后联合治疗组心率[(124.39±10.07)次/min比(101.18±8.72)次/min]、C/T[(0.63±0.15)比(0.53±0.12)]、LVEDd[(43.32±4.02)mm比(40.38±3.76)mm]和血清hsCRP水平[(32.12±3.99)pg/ml比(10.29±2.08)pg/ml]降低更显著,LVEF[(45.59±9.99)%比(59.97±10.02)%]、LVFS[(24.58±5.67)%比(31.89±6.68)%]、情感指数[(70.20±10.02)分比(86.58±12.28)分]、健康指数[(73.36±8.08)分比(85.58±11.01)分]和生活满意度评分[(74.34±8.39)分比(88.12±13.35)分]升高更显著,P<0.05或<0.01.结论:卡维地洛联合缬沙坦治疗慢性心力衰竭的疗效显著,可显著降低hsCRP水平,改善患者心功能、生活质量,值得推广.
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